419 Bridging Burn Care

Abstract

The Rhode Island Burn Center is a hybrid program where high-quality burn care is delivered on many units, both pediatric and adult, throughout our hospital campus. With pressure from health insurances, patients are being discharged more frequently from the Emergency Department with larger burns than in the past, as well as more quickly after an acute hospital admission. Many patients when discharged from the hospital, require ongoing dressing changes at home with help from various community nursing agencies throughout the region. Due to the smaller number of patients with burns, community nursing agencies are infrequently exposed to burn care and therefore have limited experience with burn dressings, including types of dressings and functional application of dressings. Bridging Burn Care was implemented to address this need. A lecture titled “Basics of Burn Care” was offered to community nursing agencies by our Burn Program Manager (BPM). This lecture reviewed classification and current treatment for burns, recommendations for patient centered dressing removal, and practical application of burn dressings to encourage function. A questionnaire was distributed to the nurses to assess their comfort with burn care before and after the lecture. Co-visits to patients’ homes with a nurse from the community nursing agency and the BPM were also offered to support the nurses in the home in applying the knowledge provided by the lecture. Nurses were variable in their comfort and experience with burn care with scores of 1–3 (Ave 2.1) on a 5 point scale (1 = Not at All Comfortable, 5 = Extremely Comfortable) prior to the lecture. Their comfort with burn care increased after the lecture to an average of 3.6 on the same scale. Co-visits with a nurse from the community nursing agency and the BPM have occurred for 3 patients to-date and have been well received by both the community nurses and the patients/families. This bridge provides continuity of the patient’s burn care during the transition from the hospital to home, supports the community nurses knowledge/application of burn care, and promotes ongoing communication with the Burn Center. With the smaller volume of patients with burns that our region receives, it is difficult for community nurses to remain up-to-date with the latest treatments for burns and maintain their confidence and competence with burn dressings. Providing a “Burn Care Bridge” between the hospital and the community, which supports both the patient/family and community nursing agencies, improves the continuity of care and quality of the burn care that takes place in the community. These types of programs have the potential to decrease return visits to Emergency Departments, improve healing, and optimize function allowing patients with burns to return to activities of daily living sooner.